• Small for Gestational Age

    (SGA, Intrauterine Growth Restriction)

    Definition

    A baby who is small for gestational age (SGA) has a significantly lower weight than other babies of the same gestational age. Gestational age is the number of weeks into pregnancy.
    Newborn
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    If parents have small stature, the baby may be small. These babies have normal development but are just small compared to others their age.
    SGA sometimes occurs if there are growth and development problems before birth. These may occur with:
    • Problems with the supply of nutrients and oxygen to the baby or a small uterus
    • Exposure to toxic substances or certain medications
    • Infections or chronic illness during pregnancy
    • Birth defects
    • Genetic syndromes

    Risk Factors

    Parents with small stature increase the risk of SGA.
    Maternal factors that can affect a baby’s growth during pregnancy include:
    Other factors that can affect baby’s growth include:

    Symptoms

    Symptoms of SGA include a birth weight that is in the lowest 10% of babies with of the same gestational age.

    Diagnosis

    A baby with SGA is often diagnosed before birth based on measurements taken of the mother’s abdomen, the mother’s weight, and size of the uterus (womb). If the measurement is low for the number of weeks of pregnancy, then the baby may be smaller than average. SGA may also be diagnosed at birth based on the baby’s weight and height.
    Images may be taken during pregnancy with an ultrasound.

    Treatment

    Talk with your doctor about the best treatment plan for your baby. A baby with SGA is at higher risk for problems, such as difficulty feeding, blood sugar abnormalities, and breathing problems. Your baby’s health and development will be monitored closely.
    Babies that have SGA due to lack of nutrition or oxygen may need treatment. Options include:

    Before Delivery

    Before your baby is born, the doctor may:
    • Monitor your baby’s growth progress closely
    • Deliver your baby early if the uterus is too small to allow your child to develop or there are problems with the mother’s health or the placenta that are affecting the babies growth
    • Treat or try to improve the treatment of any conditions that you have

    After Delivery

    Babies who are born with SGA may be weak and unable to feed properly or stay warm. Treatment may include:
    • Using warming beds or incubators
    • Providing tube feedings
    • Monitoring oxygen levels
    Ongoing monitoring and treatment may be needed during childhood.

    Prevention

    SGA due to family traits, syndromes, and uterine abnormalities cannot be prevented.
    If you are thinking of becoming pregnant, taking a supplement containing folic acid may reduce the risk of having a small for gestational age baby.
    To help reduce your baby’s chance of getting SGA due to nutrition and oxygen problems during birth, take these steps during pregnancy:
    • If you smoke, talk to your doctor about ways to quit.
    • If you use drugs or alcohol, ask your doctor to refer you to a treatment program that will help you stop.
    • Start prenatal care early and continue throughout pregnancy.
    • Keep any chronic condition under good control.

    RESOURCES

    American Pregnancy Association http://americanpregnancy.org

    Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

    CANADIAN RESOURCES

    Canadian Paediatric Society http://www.cps.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Intrauterine growth restriction (IUGR). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 11, 2015. Accessed November 24, 2015.

    Intrauterine growth restriction (IUGR); Small for gestational age (SGA). American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancycomplications/iugr.htm. Updated August 2015. Accessed November 24, 2015.

    Small for gestational age. Lucile Packard Children’s Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/sga.html. Accessed November 24, 2015.

    Small for gestational age babies. Patient UK website. Available at: http://www.patient.co.uk/doctor/small-for-gestational-age-babies. Updated May 28, 2013. Accessed November 24, 2015.

    Small for gestational age introduction. The MAGIC Foundation website. Available at: http://www.magicfoundation.org/www/docs/111. Accessed November 24, 2015.

    11/19/2013 DynaMed’s Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Roos N, Neovius M, et al. Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study. BMJ 2013;347:f6460.

    3/17/2015 DynaMed’s Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Hodgetts V, Morris R, et al. Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small-for-gestational age neonates: a population study, systematic review and meta-analysis. BJOG. 2015 Mar;122(4):478-490.

    7/7/2016 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Pamidi S, Marc I, et al. Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study. Thorax. 2016 Apr 15.

    7/15/2016 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Saccone G, Berghella V, Sarno L, et al. Celiac disease and obstetric complications: a systematic review and metaanalysis. 2016;214(2):225-234.

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